Campbell’s is the first orthopaedic text book that has transitioned to the digital age! The app is not the complete 4-volume text, rather this is “core techniques,” which includes brief summaries of 242 common surgical and bedside procedures accompanied by images and videos. The app is divided into the four volumes of the full book with their corresponding subheadings. For example, the app includes 26 surgical approaches, such as removal of iliac bone graft, anterolateral approach to the humerus, and z-plasty. Most descriptions are brief with 2-5 images, and would serve as a “refresher” for a senior resident or surgeon familiar with a procedure, or as an introduction for a medical student or junior resident who needs a quick orientation before a case. However, in addition to the many brief entries, some topics are reviewed completely with 20-30 images and videos up to 15-20 minutes in length. These videos are incredibly detailed and review how to perform full surgical procedures. Examples of “complete” entries with videos and images include femoral nailing, ACL reconstruction, SLAP repair, rotator cuff repair, chevron osteotomy, compartment syndrome fasciotomy, shoulder hemiarthroplasty, and carpal tunnel release – I counted a total of 23 videos within the app. Unlike many other apps that offer videos, all media is completely contained within this app and downloaded to the device, which explains the download size of over 800mb, but also has the great benefit of full access 100% of the time (i.e. review surgical techniques on an airplane). Lastly, the app has a very good search feature that scans all topic titles and text within the app.
Overall, Campbell’s Operative Orthopaedics is the first orthopaedic text to “go digital” with an incredibly useful reference app that is ideal for junior orthopaedic surgery residents. Although considered an expensive app at $100, compare this to list price of nearly $800 for the 4-volume print version. Of course, the app is not the complete text, but is most useful to trainees who may frequently use the app as a “refresher” between operative cases. The interface is well designed, the images and text are clear, and the search function is invaluable. In addition, consider that the purchase price includes ownership for life with all associated updates. Campbell’s is a very highly recommended app for those who can afford it.

CORE has set the standard for a clinical exam app. Divided by body part, body region, alphabetical, favorites, or search – the app contains a database of nearly 250 clinical tests which includes a purpose, instructions, video demo, and test properties. The most striking feature of this app, in addition to the vast collection of tests and videos, is actually the “properties” tab. For every test, data is presented regarding the sensitivity, specificity, likelihood ratio, accuracy and other relevant statistical tests based on primary literature references. These lists are incredibly complete. For example, the hip impingement test lists 10 primary sources with their respective sensitivities and specificities using the impingement test to detect labral tears. In addition, by selecting the primary references the user is directed to the full literature source with the abstract text. This is a feature that I have not seen replicated by any other orthopaedic reference. In the basic version of the app, the videos are not contained within the app, but rather link to YouTube videos that can be emailed/shared with colleagues. However, for an in-app purchase of $7.99 all videos can be downloaded to the device (about 1GB of data). Tests can be marked as a “favorite” and quickly reviewed at a later time. Unfortunately, the search feature was not ideal. When I searched “grind” there were “no results” but when I searched “Apley” I was provided with Apley’s Grind Test; however, this function is easily improved in a future update. This app seems ideal for a medical student with an interest in musculoskeletal medicine (PM&R, sports medicine, or orthopaedic surgery) or a junior resident in any of these fields. Overall, a very complete and useful app for trainees.

This is a useful coding app designed specifically for surgeons who perform hand surgery. The app download is free and includes 2 sections, however the complete 14-sections download require an in-app purchase of $49.99. The taskbar is organized into four sections. The “patients” tab allows the user to add patient records and includes information such as facility, date/time, patient info, assistant, and comments. That record can then be associated with the second section: CPT. CPT codes are organized by body region and separated by the usual CPT categories. A search function is available, and the user can identify favorite codes to save time during future entries. The codes themselves include options to include modifiers and the interface is easy to navigate. The third tab is a patient history section, and the fourth tab is a configuration tab where the user can enter facilities and surgical assistants. The program includes help alerts for every screen that are initially informative, but must be turned off in the configuration tab because they quickly become bothersome. Overall, the app is one of many coding apps available and will appeal to many surgeons, however there does not appear to be support for ICD-9 codes if that is an important feature to you.

A fracture classification reference, this app has an intuitively simple interface with the potential for great utility when describing/classifying fractures. The apps is divided into 2 main sections: adult and pediatric trauma. Sub-classifications include various joints and bones with matching thumbnail images to orient the user. Once selecting a specific region (i.e. distal radius), the app then presents multiple classification systems for that region (i.e. Frykman, AO, Fernandez, Melone, Universal, etc.) as well as their accompanying images (typically taken directly from the primary source), and references. Having such a well-organized reference list is worth the download in itself. It is worth noting that the summaries for each fracture are brief, and presented only in table format. Thus, this app is clearly designed for physicians/trainees who already have a basic knowledge of the fracture pattern and involved structures. Lastly, the app has a useful “search” function which worked very well. Overall, a good reference app for trainees and surgeons needing to classify many fracture patterns.

The developers of Scores-SF36 have elegantly converted the standard SF-36 clinical questionnaire into an intuitive and easy-to-use iPhone and iPad app. The app offers no surprises, and has the added benefit of being available in both English and French. After entering the patient’s name, the user is seamlessly walked through each question of the survey with instructions for how to answer each question. The results are then saved in the device, and sub-scores are calculated as well. The data can then be emailed in a .csv file. Unfortunately, when testing the save/email features, I found that the iPad version has a bug that did not email the actual scores, which renders the email function useless. In addition, on the iPhone version, the email .csv file only includes the summary scores for each section, but does not include the answers to each individual question – data that is, in fact, saved on the device because it can be reviewed at a later date. Thus, the app could benefit from some increased functionality that would likely be useful in a research setting. Overall, the app is a very good use of technology to assist with recording patient outcomes and could have significant potential time-savings in the research settings since data is recorded and saved digitally.

The developers of Scores-ODI have elegantly converted the standard Oswestry Disability Index clinical questionnaire into an intuitive and easy-to-use iPhone and iPad app. The app offers no surprises, and has the added benefit of being available in both English and French. After entering the patient’s name, the user is seamlessly walked through each question of the survey with instructions for how to answer each question. The results are then saved in the device and the app suggest that the data can then be emailed in a .csv file. Unfortunately, when testing the save/email features, I found that the iPad version has a bug that did not email the actual scores, which renders the email function useless. In addition, on the iPhone version, the email .csv file did not appear to send an accurate score. Thus, the app could benefit from some increased functionality that would likely be useful in a research setting. Overall, the app is a very good use of technology to assist with recording patient outcomes and could have significant potential time-savings in the research settings since data is recorded and saved digitally.

This app is a useful utility for any orthopaedic surgeon or physician who treats limb-length discrepencies or needs a limb-length, trunk-height, or total height prediction tool. Based on the publications and equations developed by Dr. Paley, and produced by Dr. Paley himself, the app is organized into 6 sections: discrepancy, bone length, fetal, height, sitting height, achondroplasia, and “other charts” which includes supporting tables, charts, and diagrams. Each main section is organized into sub-categories to help a provider identify the appropriate equation. Once the proper function as been selected, the app is as easy as entering the patients age, gender, and relevant values (limb length, current height, discrepancy, etc.). Overall, the app provides a free and invaluable tool for physicians who use the multiplier method in their clinical practice.

CobbMeter joins a number of apps that utilize the iPhone’s internal accelerometer to conveniently measure clinically relevant angular measurements. In this case, the app is beautifully designed to assist with the measurements scoliosis, kyphosis, and sacral slope. The user interface is very simple and intuitive and includes the ability to save and email data for specific patients. One thing that sets this app apart from other goniometric devices is the elegant interface, as well as the ability to receive the angular results via either a male or female voice. Unfortunately, at a price of $19.99, this app is somewhat expensive given its limited function and less expensive competitors. However, for providers that intend to use this app regularly and appreciate the nice design, this may be a good investment.

OrthoMeter joins a number of apps that utilize the iPhone’s internal accelerometer to conveniently measure clinically relevant angular measurements. In this case, the app is beautifully designed to assist with the measurements of an angle between two lines, an angle measured from the horizontal, and an angle measured off the vertical. For the three functions, the images provided suggests arthroplasty functions, such as the distal femoral angle, the alpha angle of the hip, and acetabular cup version, respectively. The user interface is very simple and intuitive and includes the ability to save and email data for specific patients. One thing that sets this app apart from other goniometric devices is the elegant interface, as well as the ability to receive the angular results via either a male or female voice. Unfortunately, at a price of $11.99, this app is somewhat expensive given its limited function and less expensive competitors. However, for providers that intend to use this app regularly and appreciate the nice design, this may be a good investment.